Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or Maine for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Maine only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. Maine (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

St. Mary's Regional Medical Center (NPI 1447226584)

Field	Value
Entity Type	Organization
Organization	St. Mary's Regional Medical Center
Address	93 Campus Ave
City	Lewiston
State	ME
ZIP	04240
Taxonomy	General Acute Care Hospital
NPI Enumerated	February 28, 2006

Payer Source	Total Paid
Medicaid	$67.4M
Medicare	$0

Key Findings

ST. MARY'S REGIONAL MEDICAL CENTER reports no Medicare billing on file and $67.4M in lifetime Medicaid revenue, making its observable public-payor activity effectively single-payer (Medicaid) in scale based on the available claims data. The absence of Medicare claims suggests analyses of this facility should focus on Medicaid-driven volumes and competitive dynamics within Maine rather than cross-payer comparisons.

Revenue is highly concentrated in a small set of outpatient and emergency codes: G0463 generates $13.8M (26.0% of Medicaid revenue) and the precomputed top-three codes together account for 50.3% of the provider’s total Medicaid revenue. That concentration indicates a reliance on hospital outpatient clinic visits and emergency/ED evaluation and management services as the primary Medicaid revenue drivers.

Emergency department E/M codes are dominant across the top revenue list — 99283 ($6.8M, 12.8%), 99284 ($6.1M, 11.5%), and 99285 ($5.9M, 11.1%) — signaling that ED evaluation and management comprises a large share of clinical activity billed to Medicaid. These volumes point to a service model with substantial acute care and ED throughput.

G0463 ($13.8M, 26.0%) ranks #6 of 55 providers in-state (91th percentile) and is described as typical/unremarkable volume for this code, whereas 99283 ranks #2 of 53 providers (98th percentile) and is labeled notably above typical state volume. Together these rank/percentile positions indicate the facility is a significant in-state provider for emergency visits, with especially strong volume at the 99283 level.

Several codes show extreme or top-in-state activity that defines specialty or high-volume service lines: 90792 (psychiatric evaluation) is $1.2M and ranks #1 of 48 providers (100th percentile), 20610 (joint injection) is $608.3K and ranks #1 of 36 providers (100th percentile), 11042 (debridement) is $548.5K and ranks #1 of 14 providers (100th percentile), and 29581 (layered compression bandage) is $482.2K and ranks #1 of 10 providers (100th percentile). These #1 rankings suggest the hospital is the leading Medicaid provider in Maine for several procedural and behavioral health services.

Outpatient primary and behavioral health services are prominent: 99214 ($3.1M, 5.8%) and 99213 ($1.8M, 3.4%) are extreme outliers in-state (both 99th percentile), and H2012 (behavioral health day treatment) contributes $3M (5.7%) and ranks #5 of 42 providers (90th percentile). This mix signals a substantial ambulatory and mental/behavioral health footprint alongside the ED and inpatient-related services.

Service mix also includes supportive inpatient/observation and procedural volumes: 99232 (subsequent inpatient/observation care) appears at $732.1K (1.4%) and ranks #4 of 70 providers (96th percentile), while infusion/IV administration and initial infusions (96374 at $1.1M and 96365 at $492K) and imaging/CT (74177 at $730.6K) show the hospital provides a broad set of acute and procedural services billed to Medicaid. These entries underline that revenue is not limited to triage/ED visits but extends into diagnostics, infusions, and inpatient follow-up.

The provider’s NPI tenure (enumerated 2006-02-28, ~20 years ago) shows long-standing operational presence in the market; combined with multiple top-percentile ranks and several #1 in-state positions, the facility appears to be an established regional hub for emergency, outpatient clinic, behavioral health, and selected procedural services within Maine’s Medicaid network.

Medicaid: Complete Services Breakdown

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

564 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
G0463	Hospital outpatient clinic visit for assessment and management of a patient	230,410	$60	$13.8M
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	69,300	$100	$6.8M
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	47,730	$130	$6.1M
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	18,760	$320	$5.9M
99214	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a moderate level of medical decision making, and/or the…	96,340	$30	$3.1M
H2012	Behavioral health day treatment, per hour	40,950	$70	$3M
99213	The provider sees an established patient for an office visit or other outpatient visit involving evaluation and management. The visit involves a low level of medical decision making, and/or the…	74,780	$20	$1.8M
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	20,940	$60	$1.2M
90792	In this procedure, the provider performs a psychiatric evaluation of the patient with the aim of making a diagnosis. In addition to the diagnostic evaluation, he also renders some additional medical…	18,950	$60	$1.2M
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	11,410	$90	$1.1M

Showing 1–10 of 564

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Maine providers billing the same CPT/HCPCS codes.

Claims Volume vs. Maine Distribution

St. Mary's Regional Medical Center — 11 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Maine

Full comparison — all codes billed, vs. Maine median

564 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
H2012	Behavioral health day treatment, per hour	5	40	13,180	$230	$5.1M
G0463	Hospital outpatient clinic visit for assessment and management of a patient	6	60	18,740	$60	$4.6M
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	5	60	9,550	$100	$1.5M
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	5	60	4,690	$180	$1.5M
T1017	Targeted case management, each 15 minutes	89	100	4,690	$90	$1M
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	2	50	11,590	$60	$942.4K
J1745	Injection, infliximab, excludes biosimilar, 10 mg	8	10	200	$1,690	$796.1K
J0585	Injection, onabotulinumtoxina, 1 unit	4	20	1,240	$380	$618.9K
96374	The provider administers a single medication or other substance rapidly into a vein to treat, prevent, or diagnose a condition.	7	30	6,230	$70	$515.4K
A0427	Ambulance service, advanced life support, emergency transport, level 1 (als 1 - emergency)	11	100	670	$200	$363.5K

Showing 1–10 of 564

Related Providers

Other providers that share a Tax Identification Number (TIN) with St. Mary's Regional Medical Center, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
St. Mary's Regional Medical Center	ME	Urgent Care Clinic/Center	$0	$1.3M
Mirela Andrei	WA	Medical Oncology Physician	$1M	$0
Lauren Blais	ME	Family Nurse Practitioner	$111.3K	$0
Eric Black-maier	GA	Clinical Cardiac Electrophysiology Physician	$104.9K	$0
Charles Carpenter	ME	Clinical Cardiac Electrophysiology Physician	$89K	$0
Edward Teufel	ME	Cardiovascular Disease Physician	$82.7K	$0
Michael Newman	ME	Orthopaedic Surgery Physician	$82.5K	$0
Joseph Wight	ME	Cardiovascular Disease Physician	$80.1K	$0
Andre Couture	ME	Emergency Medicine Physician	$79.7K	$0
James Parker	ME	Cardiovascular Disease Physician	$78.5K	$0

Nearby Providers

Other providers in the same ZIP code as St. Mary's Regional Medical Center, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Central Maine Medical Center	ME	General Acute Care Hospital	$0	$76.1M
Seniorsplus	ME	Case Management Agency	$0	$74.6M
Support Solutions Inc	ME	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$72.9M
Alternative Services-ne, Inc.	ME	Intellectual and/or Developmental Disabilities Residential Treatment Facility	$0	$71.6M
Coastal Community Care, LLC	ME	Community/Behavioral Health Agency	$0	$24.1M
Androscoggin Home Health Services, Inc.	ME	Home Health Agency	$0	$20.6M
R.i.s.e., Inc.	ME	In Home Supportive Care Agency	$0	$18.5M
Community Clinical Services, Inc.	ME	Federally Qualified Health Center (FQHC)	$0	$17.3M
Bright Future Healthier You	ME	Case Management Agency	$0	$17.1M
Pediatric Associates Of Lewiston P.A.	ME	Pediatrics Physician	$0	$13.2M

St. Mary's Regional Medical Center — Billing Profile & Reimbursement Data

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St. Mary's Regional Medical Center — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References